Ch. 376                                     1993 LAWS OF MARYLAND

(I)      THE FORWARDING OF A PATIENT BY ONE HEALTH CARE
PRACTITIONER TO ANOTHER HEALTH CARE PRACTITIONER OR TO A HEALTH CARE
ENTITY OUTSIDE THE HEALTH CARE PRACTITIONER'S OFFICE OR GROUP PRACTICE;
OR

(II)     THE REQUEST OR ESTABLISHMENT BY A HEALTH CARE
PRACTITIONER OF A PLAN OF CARE FOR THE PROVISION OF HEALTH CARE
SERVICES OUTSIDE THE HEALTH CARE PRACTITIONER'S OFFICE OR GROUP
PRACTICE.

1-302.

(A)     EXCEPT AS PROVIDED IN SUBSECTION (D) OF THIS SECTION, A HEALTH
CARE PRACTITIONER MAY NOT REFER A PATIENT, OR DIRECT AN EMPLOYEE OF OR
PERSON UNDER CONTRACT WITH THE HEALTH CARE PRACTITIONER TO REFER A
PATIENT TO A HEALTH CARE ENTITY:

(1)      IN WHICH THE HEALTH CARE PRACTITIONER, THE PRACTITIONER'S
IMMEDIATE FAMILY, OR THE PRACTITIONER IN COMBINATION WITH THE
PRACTITIONER'S IMMEDIATE FAMILY OWNS A BENEFICIAL INTEREST; OR

(2)      WITH WHICH THE HEALTH CARE PRACTITIONER, THE
PRACTITIONER'S IMMEDIATE FAMILY, OR THE PRACTITIONER IN COMBINATION
WITH THE PRACTITIONER'S IMMEDIATE FAMILY HAS A COMPENSATION
ARRANGEMENT.

(B)     A HEALTH CARE ENTITY OR A REFERRING HEALTH CARE PRACTITIONER
MAY NOT PRESENT OR CAUSE TO BE PRESENTED TO ANY INDIVIDUAL, THIRD
PARTY PAYOR, OR OTHER PERSON A CLAIM, BILL, OR OTHER DEMAND FOR
PAYMENT FOR HEALTH CARE SERVICES PROVIDED AS A RESULT OF A REFERRAL
PROHIBITED BY THIS SUBTITLE.

(C)     SUBSECTION (A) OF THIS SECTION APPLIES TO ANY ARRANGEMENT OR
SCHEME, INCLUDING A CROSS-REFERRAL ARRANGEMENT, WHICH THE HEALTH
CARE PRACTITIONER KNOWS OR SHOULD KNOW HAS A PRINCIPAL PURPOSE OF
ASSURING INDIRECT REFERRALS THAT WOULD BE IN VIOLATION OF SUBSECTION
(A) OF THIS SECTION IF MADE DIRECTLY.

(D)     THE PROVISIONS OF THIS SECTION DO NOT APPLY TO:

(1)      A HEALTH CARE PRACTITIONER WHEN TREATING A MEMBER OF A
HEALTH MAINTENANCE ORGANIZATION AS DEFINED IN § 19-701 OF THE HEALTH -
GENERAL ARTICLE IF THE HEALTH CARE PRACTITIONER DOES NOT HAVE A
BENEFICIAL INTEREST IN THE HEALTH CARE ENTITY;

(2)      A HEALTH CARE PRACTITIONER WHO REFERS A PATIENT TO
ANOTHER HEALTH CARE PRACTITIONER IN THE SAME GROUP PRACTICE AS THE
REFERRING HEALTH CARE PRACTITIONER;

- 2074 -